Children with ADHD can improve without resorting to drugs, research finds

Extra support in classrooms can help children with Attention Deficit Hyperactivity Disorder (ADHD) do better without the need for drugs, a new study has found.

But so many different strategies have been tried in order to help these children, who are typically restless and struggle to concentrate, that researchers cannot clearly identify which ones work best.

The review of 54 studies, led by the University of Exeter Medical School, concluded that non-drug interventions in schools may be effective in improving how children with ADHD perform in tests. Prescriptions for Ritalin and similar drugs used to treat ADHD rose by 50 per cent in England in the five years from 2008 to 2013.

The 54 different studies tested many different ways of supporting these children, such as having daily report cards from teachers or training children in study and organisational skills.

Overall, such strategies could help children achieve better attainment levels, reduce hyperactive behaviour and increase attention, said the review, published in the journal Health Technology Assessment today.

But the studies looked at many different types of strategies, often combined in different ways and using different measurements to assess whether they worked, making it impossible to discover how best to help.

Professor Tamsin Ford, from the University of Exeter Medical School, led the study, which involved collaborators from King's College London and the Hong Kong Institute for Education. She said: “There is strong evidence for the effectiveness of drugs for children with ADHD, but not all children can tolerate them or want to take them. ADHD can be disruptive to affected children as well as the classroom overall, but our study shows that effective psychological and behavioural management may make a significant improvement to children’s ability to cope with school.

"While this is encouraging, it’s not possible to give definitive guidance on what works because of variations between the strategies tested, and the design and analysis of the studies that we found."

The research team also found that studies of attitudes and experience suggest that differences in beliefs about ADHD can create tensions in relationships between teachers, pupils and parents - and that the culture in the classroom could influence how effective the support was.

The review concluded that educating school staff and the public about ADHD would help to break down preconceptions.